Gerontology is the study of health issues that go with old age and aging. It’s a medical specialty because, like the very young, older people have different biological, psychological and sociological needs. Medicare, the health insurance program that covers people in the U.S. starting at age 65, addresses many of the financial concerns of this population, but what about the hands-on care?
In a blog posted on KevinMd.com, Dr. Steven Reznick, an internal medicine physician, writes about his elderly parents residing in an assisted living facility. They are cognitively impaired, so he’s in contact with their personal physician, and lives nearby. They are lucky.
What if the circumstances were different? “What,” he asked, “would I look for in a physician for my elderly parents if they did not live close by?” Here’s his advice to older patients and their loved ones for choosing the right doctor.
- Find someone with experience in geriatric medicine. Such practitioners have training and certification from the American Geriatrics Society. A board-certified internist or family practitioner with experience in caring for the elderly also might be fine. Either specialist should be available by phone for questions and to see patients on the same day that they develop a problem requiring a doctor’s attention.
- The doctor should have hospital privileges at a local facility where patients might be taken by ambulance in an emergency. You want someone who can follow the patient into an acute care hospital if necessary. He or she also should have a professional relationship with a rehabilitation or skilled nursing facility so that patients can be treated in a rehab facility as they recover from an acute hospital stay.
- The doctor should be a compassionate individual; a great listener and energetic advocate for his or her patients. It’s all too common for elderly patients to be marginalized, to languish waiting for evaluation in the emergency department or when trying to make an appointment for a test or specialty visit. While a strong family member or other patient advocate (see our blog about patient advocates) can assume this responsibility, some older people lack such support, and the doctor is their last hope.
In addition, we would add that an elderly patient’s doctor should be very familiar with end-of-life issues. See our newsletter about who speaks for you when you can’t communicate your wishes.
Most of Reznick’s advice pertains pretty much to anyone seeking quality care from a doctor. Who doesn’t want someone compassionate, who doesn’t want someone available? But older people are among the weakest members of society, and often reluctant (or unable) to stand up for themselves. Qualities that are merely preferable for everyone might be critical for them.
To locate a suitable practitioner for an elderly patient:
- Search the Medicare referral site.
- Inquire at the local hospital medical staff office-those folks know who practices what and who’s accepting new Medicare patients.
- Ask people you know whose values are similar to yours.
- Inquire at local and county medical societies.
- Beware of Internet sites such as Yelp and other crowd-sourced referrals-everyone’s experience is different, and if a stranger is making the referral, how do you know your tastes and values are similar?
- Interview prospective doctors; if they decline because they’re too busy, they’re not good candidates.